Provider Demographics
NPI:1235287418
Name:WHITEBIRD ORANGE, KAYT (PHD)
Entity Type:Individual
Prefix:
First Name:KAYT
Middle Name:
Last Name:WHITEBIRD ORANGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAYT
Other - Middle Name:
Other - Last Name:WHITEBIRD ORANGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 4902
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NM
Mailing Address - Zip Code:87533-4902
Mailing Address - Country:US
Mailing Address - Phone:505-927-5770
Mailing Address - Fax:
Practice Address - Street 1:CTY RD 59 HSE #430
Practice Address - Street 2:
Practice Address - City:VELARDE
Practice Address - State:NM
Practice Address - Zip Code:87582
Practice Address - Country:US
Practice Address - Phone:505-927-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1065103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist